Although the traditional method of open surgery for lumbar disc herniation has very obvious clinical effects, however, with the continuous improvement of people’s overall quality and living standard, the drawbacks brought by open surgery to patients are no longer accepted by everyone, therefore, minimally invasive treatment methods with less trauma, faster recovery, less pain, good effect, low cost, safe and reliable have come into being. However, the traditional minimally invasive treatment methods including collagenase dissolution, percutaneous cut and suck, laser vaporization (PLDD), low-temperature plasma ablation, radiofrequency ablation, ozone target injection and other minimally invasive ablation procedures are indirect decompression within the disc, which cannot completely remove the diseased medullary nucleus, especially the tissue compressing the nerve, repair the broken fiber ring, or release the compressed nerve, and the necrotic tissue needs to be absorbed naturally by the body. As a result, the treatment is ineffective, questioned by everyone, and gradually abandoned. The application of posterior discoscopy (MED) can remove the herniated disc tissue under direct vision, and the effect is reliable if no complications occur, but because the surgical approach and treatment process are consistent with small incision open surgery, it is necessary to implement the lamina opening, peel off the muscles and ligaments, disturb the spinal canal and pull the nerves; it is easy to cause intraoperative bleeding, interfere with the visual field and increase the risk; postoperative scar tissue is easy to cause adhesions of the spinal canal and nerves; It cannot be applied to the treatment of extreme lateral herniation and discogenic pain; its indications are narrow and it has not been promoted, and its effectiveness has been questioned because of many complications. For these reasons, some people wonder “can minimally invasive surgery treat lumbar disc herniation? Especially for patients with combined spinal stenosis”. The introduction of the fourth generation of minimally invasive intervertebral foraminoscopy technology has solved the problems that cannot be solved by the above minimally invasive technology. Percutaneous lumbar discectomy assisted by percutaneous endoscopy is developed on the basis of percutaneous autotomy and aspiration of the intervertebral disc. A 7.5 mm diameter surgical working channel is inserted directly into the disc or spinal canal through the intervertebral foramen under local anesthesia, and the protruding or prolapsing discs can be directly removed and the nerves released under direct endoscopic view. Since the operation is performed under local anesthesia, the important ligamentous structures of the lumbar spine are not damaged during the operation. It has no effect on the stability of the lumbar spine, does not require pulling the nerve roots and dural sac, does not significantly harass the nerve tissues in the spinal canal, and does not cause significant bleeding and adhesions in the spinal canal, and has the advantages of small surgical trauma, good results, short postoperative bed time, low surgical cost and fast recovery. The two most commonly used procedures in clinical practice are the YESS technique of indirect disc decompression through the Kambin safety triangle and the TESSYS technique of direct nerve root release and decompression through the intervertebral foramen into the spinal canal designed by Hoogland et al. Not only can they treat general types of lumbar disc herniation, but also have greater advantages than traditional open surgery for the treatment of special types of lumbar disc herniation (including adolescent, elderly, recurrent, extreme lateral, ruptured and combined spinal stenosis, etc.). With the improvement of surgical skills and the improvement of the operating instruments under the scope, the indications will be expanded continuously. However, in clinical application, it is necessary to select different cases and establish individualized protocols according to the operating skills of the surgeon and the different conditions of the patient, so as to achieve the best therapeutic effect with the least trauma. The Tessys technique and Yess technique are used to avoid risks, and the “targeting” technique is used to reach the lesion area, which can successfully and safely remove the disc tissue and decompress and release the nerve. It will definitely be more widely promoted and applied.